When To Worry About A Cough

How long this symptom should linger

Has your annoying cough been dragging on for weeks? It’s annoying for sure, but it’s also totally normal. People tend to underestimate how long a cough should last, according to a new study published in the Annals of Family Medicine. Skewed expectations may be one reason why antibiotics are over-prescribed, even for viral infections.

In a phone survey, researchers asked 493 people how long they thought a case of ACI (acute cough illness, a.k.a. a cold that causes coughing) should last. At the same time, they looked at the existing medical literature to see how long ACI actually lasts on average. Survey respondents guessed that a cough should last 7-9 days. The literature, by contrast, showed that the mean duration of a cough is almost 18 days.

That much hacking sounds excessive, which helps explain why many people would be tempted to see a doctor much sooner than that. Doctors may feel pressured to prescribe antibiotics, even when it’s unnecessary or (in the case of a viral infection) useless.

There’s a reason we get anxious about a lingering cough, says lead study author Mark H. Ebell, MD, MS, an associate professor at the University of Georgia. “There are a lot of infections like the common cold...that last maybe a week to 10 days,” he says. “I think people extend that to bronchitis or a chest cold and think it should last that long as well.” Some coughs hang around for longer, and as inconvenient as they can be, we need to allow ourselves enough time to recover. “Americans are not known for being the most patient people in the world,” Dr. Ebell adds.

Knowing the actual timeline can keep you from getting freaked out for no reason. Still, there are signs to watch out for, says Meir Kryger, MD, a professor of pulmonary medicine at the Yale School of Medicine. Watch to see if your cough has a creepy partner in crime, like funky-looking or excessive phlegm. “If you’re coughing and you’re bringing up something, it’s usually something you should go to the doctor for,” Dr. Kryger says. Also watch for changes in the color of your phlegm or traces of blood, both of which merit a trip to the doc.

If your cough is accompanied by shortness of breath or a wheezing noise in your chest, it’s also smart to get checked out. A barking or whooping sound, accompanied by a coughing spasm, could be a sign of adult whooping cough, which Dr. Kryger says is on the rise. In addition, some coughs can be caused or aggravated by certain medications, like those used to treat high blood pressure.

While you may not be breathing easy in just one or two weeks’ time, see a doc if you have any of the above symptoms. “It’s better to be safe than sorry,” Dr. Kyger cautions.